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THE MUSINGS OF A TRADITIONAL SOUTHERN DEMOCRAT

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Friday, March 13, 2015

Senate Republicans’ Budget Targets Medicaid, Food Stamps - Potential savings of hundreds of billions of dollars; leader of Democratic caucus on budget panel vows fight

From TheWall Street Journal:

WASHINGTON—The Senate Republican budget slated for release next week is expected to generate savings by turning more responsibility for Medicaid and food-stamp programs over to states, GOP lawmakers and aides said Thursday.

While details of the document aren’t final, Republicans would propose turning funding for those programs into something similar to a block grant, said Senate Budget Committee Member Lindsey Graham (R., S.C.). That approach would call for the federal government to pay states a lump sum, instead of a percentage of the program’s costs. States would have more control over the program and would be responsible for footing the rest of the bill.

“It’s just a better way to give flexibility on the ground, where people are at,” Mr. Graham said. “The more you manage something far away, the more costly and less efficient it becomes.”

Under the current system, Medicaid programs are administered by the states, but an average of 57% of their budgets come from federal funds, according to the National Association of State Budget Officers. Republicans have proposed similar moves in the past, but have encountered Democratic resistance.

“I will do everything in my power to make sure we pass a budget that does not harm the most vulnerable Americans,” said Sen. Bernie Sanders (I., Vt.), the top member of the Democratic caucus on the Senate Budget Committee, in a statement Thursday.

To get a sense of potential savings, under last year’s House GOP budget, converting the food-stamp programs into a block grant starting in 2019 would have saved $125 billion over 10 years. The document also estimated that overhauling Medicaid would trim $732 billion over a decade.

Not all Republicans support the idea of turning food stamps into a block grant-type program.

“The governors would love the money, but they don’t want to be in charge of food stamps,” said Sen. Pat Roberts (R., Kansas), the Agriculture Committee chairman.

The new details come as the two parties prepare to unveil dueling priorities for setting spending for the next fiscal year, which starts in October. Senate Republicans say they expect their budget resolution will make no changes to Social Security and will propose overall spending for Medicare, the federal health-insurance program for the elderly and disabled, at the same level proposed by the White House budget earlier this year, according to a GOP lawmaker.

“I believe Medicare reforms will be similar to what the president has proposed,” Sen. Mike Crapo (R., Idaho), a member of the Senate Budget Committee, said Thursday. Mr. Crapo said the GOP budget would differ somewhat from President Barack Obama’s proposal on Medicare, because Republicans will include their own changes to the Affordable Care Act, the 2010 health-care law.

It wasn’t clear Thursday whether the Senate GOP budget would include a proposal from former House Budget Committee Chairman Paul Ryan (R., Wis.) that has been one of the most contentious pieces of previous House GOP budgets. Mr. Ryan has called for overhauling Medicare to allow Americans who turn 65 in the future to choose between private insurance plans with government support for premiums or staying in traditional Medicare, though their costs could rise.

Democrats have attacked Republicans for backing Mr. Ryan’s Medicare proposal, known as “premium support.” While many House Republicans have supported the idea, some Senate Republicans are wary.

Senate GOP lawmakers represent a full state, encompassing a broader ideological range, and some view the proposal as a political liability without any shot of being signed into law during the final two years of Mr. Obama’s presidency, a Senate GOP aide said.

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